Open AccessArthroscopic-assisted percutaneous fixation of intra-articular calcaneal fractures using an intraoperative distraction device
Author(s) -
Di Gao,
TM Wong,
Christian Fang,
Frankie Leung,
Xiang Li,
Bin Jia,
Yu Wang,
Bin Yu
Publication year - 2021
Publication title -
journal of orthopaedic surgery
Language(s) - English
Resource type - Journals
eISSN - 2309-4990
pISSN - 1022-5536
DOI - 10.1177/2309499020979095
Subject(s) - medicine , ankle , percutaneous , subtalar joint , surgery , visual analogue scale , reduction (mathematics) , calcaneal fracture , internal fixation , calcaneus , fixation (population genetics) , population , geometry , mathematics , environmental health
Purpose: To evaluate the quality of reduction and clinical outcomes by using Percutaneous Distractor and Subtalar Arthroscopy Closed Reduction followed by Internal Fixation (PDSA-CRIF) in the intra-articular calcaneal fracture.Methods: A consecutive case series of 453 patients with 507 displaced intra-articular calcaneal fractures was recruited in this retrospective study. We performed PDSA-CRIF to treat intra-articular calcaneal fractures. The quality of reduction was assessed by early postoperative Computed Tomography (CT) scans and measurement of serial Bohler’s angles during follow-ups. Clinical outcomes were evaluated by Visual Analogue Scale (VAS) and the American Foot & Ankle Society ankle-hind foot scale (AOFAS) scoring system.Results: Fifty-nine patients (68 fractures) who had complete clinical data and follow-up of at least 12-months (mean: 14 months, range: 12–59 months) were finally included. Anatomical and near-anatomical reduction in subtalar articular surface which had less than 2 mm gap or step-off was found in 93% fractures. Unsatisfactory reduction was found in 7%.Conclusion: Arthroscopic-assisted percutaneous fixation using a distraction device is effective in achieving positive short-term results in the displaced intra-articular calcaneal fractures. A multicenter, large sample, randomized control trial is needed to fully evaluate the long-term effects of PDSA-CRIF in comparison to other methods.